The Commission receives and deals with complaints involving individual health practitioners, such as doctors, optometrists and acupuncturists, and health service organisations, such as hospitals.
Complaints about health organisations involve different procedures from those made about individual health practitioners. This is indicated in the two process flowcharts shown below.
To view more information for each step please move your mouse over the flowcharts below.
Refer to professional council
Resolved during assessment
Prohibition order/public statement
Refer to professional council
Refer to the Director of Proceedings
Refer to the Director of Public Prosecutions
Monitor implementation of recommendations
Complaint proved/not proved
1. Refer to professional council
The commission can refer a complaint about a registered practitioner to the relevant professional council to consider taking action such as counselling, performance management or action regarding impairment.
The commission can discontinue dealing with a complaint for many reasons - for example, the time that has passed since the incident makes it difficult to investigate the complaint effectively.
3. Refer to another body
In some cases, the complaint may be referred to another body that is more suitable to deal with the issues
of concern. For example, a complaint about non-authorised prescribing of addictive medications – so called scheduled drugs - may be referred to the Director General of the Ministry of Health. Allegations about over-servicing can be referred to Medicare Australia while the Commonwealth Department of Health and Ageing deals with complaints about conditions in nursing homes.
4. Resolved during assessment process
Complaints may be resolved during the assessment process where the person who made the complaint is satisfied with the information and explanation that the health service provider gives in their response.
5. Referred to the Commission's Resolution Service
Complaints can also be referred to the Commission's Resolution Service. A Resolution Officer can assist the parties to resolve any outstanding issues. In some cases, an independent conciliator facilitates a meeting.
6. Investigation by commission
The Commission formally investigates complaints that raise a significant issue of public health or safety, or, if substantiated, provide grounds for disciplinary action against a registered health practitioner.
7. local resolution
Minor complaints about a public heath organisation can be referred back to the organisation to try to resolve the matter locally with the person who made the complaint, if the organisation agrees to this.
8. public statement/order
Issue a prohibition order, public statement and/or public warning. A prohibition order can ban or limit an unregistered health practitioner from providing health services. The practitioner must advise potential patients of any limitations imposed before treating them. A breach of the order is a criminal offence. The Commission can also issue a public warning where it has found a treatment or health service to be unsafe.
9. Refer to a professional council
Refer the complaint to a
professional council to take action,
including assessing the practitioner
for performance or impairment, or
counselling them about their conduct.
10. Refer to director of proceedings
Refer the complaint about a
registered practitioner to the
Director of Proceedings who
determines whether or not it should
be prosecuted before a disciplinary
body. The Director of Proceedings must
consider the protection of the health and
safety of the public; the seriousness of
the alleged conduct; the likelihood of
proving the alleged conduct; and any
submissions by the practitioner when
making this determination.
If the Director of Proceedings decides
not to prosecute a matter, it may be
referred back to the Commissioner to
consider other appropriate action.
If a matter is being prosecuted,
complaints about unsatisfactory
professional conduct will usually be
heard by a Professional Standards
Committee, while a complaint about
professional misconduct will be
prosecuted before the NSW Civil and Administrative Tribunal.
11. Make Comments
Make comments. The Commission
makes comments to registered health
practitioners where there was poor
care or treatment, but not to an extent
that would justify prosecution.
Comments can also be made to an
unregistered health practitioner where
although the conduct can be improved,
there is no risk to public health or safety.
Comments to a health organisation
are made in cases where the health
care provided was inadequate, but the
organisation has already taken measures
to prevent a similar occurrence in
12. Refer to the Director of Public Prosecution
Refer the matter to the Director of
Public Prosecutions to consider
13. Terminate the investigation
Terminate the complaint (take no
further action) where the investigation
has found no or insufficient evidence
of inappropriate conduct, care
14. Make Recommendations
Make recommendations to a
health organisation where there has
been poor health service delivery and
systemic improvements should be
made. The Commission also provides
its recommendations to the Director
General of the Ministry of Health and
the Clinical Excellence Commission
to inform their work in improving
14. (Monitoring) Make Recommendations
The Commission monitors whether
its recommendations to a health
organisation have been implemented.
If the Commission is not satisfied with
the implementation, it may, ultimately,
make a special report to Parliament.
A Professional Standards Committee or
Tribunal that finds the complaint proven
can reprimand, fine and/or impose
conditions on the practitioner.
Only the NSW Civil and Administrative Tribunal can suspend or cancel
the registration of a practitioner. The
Tribunal may also issue a prohibition
order that bans or limits a practitioner
from practising in another area of health
service – for example, a psychiatrist
whose registration is cancelled can be
banned from working as a counsellor.